CT Findings of Colonic Complications Associated with Colon Cancer

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Abstract

A broad spectrum of colonic complications can occur in patients with colon cancer. Clinically, some of these complications can obscure the presence of underlying malignancies in the colon and these complications may require emergency surgical management. The complications of the colon that can be associated with colon cancer include obstruction, perforation, abscess formation, acute appendicitis, ischemic colitis and intussusception. Although the majority of these complications only rarely occur, familiarity with the various manifestations of colon cancer complications will facilitate making an accurate diagnosis and administering prompt management in these situations. The purpose of this pictorial essay is to review the CT appearance of the colonic complications associated with colon cancer.

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Adult intestinal intussusception: CT appearances and identification of a causative lead point.

Young Kim, Michael Blake, Mukesh Harisinghani … (2015)

The widespread application of computed tomography (CT) in different clinical situations has increased the detection of intussusception, particularly non-lead point intussusception, which tends to be transient. Consequently, determining the clinical significance of intussusception seen at CT poses a diagnostic challenge. Patients with intussusception may or may not be symptomatic, and symptoms can be acute, intermittent, or chronic, making clinical diagnosis difficult. In most cases, radiologists can readily make the correct diagnosis of intestinal intussusception by noting the typical bowel-within-bowel appearance at abdominal CT. However, the CT findings that help differentiate between lead point and non-lead point intussusception have not been well studied. Nevertheless, although there is considerable overlap of CT findings, when a lead mass is seen at CT as a separate and distinct entity vis-à-vis edematous bowel, it can be considered a reliable indicator of a lead point intussusception. Differentiating between lead point and non-lead point intussusception is important in determining the appropriate treatment and has the potential to reduce the prevalence of unnecessary surgery. Copyright RSNA, 2006.

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Disproportionate fat stranding: a helpful CT sign in patients with acute abdominal pain.

José Pereira, Claude Sirlin, Pedro S. Pinto … (2015)

Fat stranding adjacent to thickened bowel wall seen at computed tomography (CT) in patients with acute abdominal pain suggests an acute process of the gastrointestinal tract, but the differential diagnosis is wide. The authors observed "disproportionate" fat stranding (ie, stranding more severe than expected for the degree of bowel wall thickening present) and explored how this finding suggests a narrower differential diagnosis, one that is centered in the mesentery: diverticulitis, epiploic appendagitis, omental infarction, and appendicitis. The characteristic CT findings (in addition to fat stranding) of each of these entities often lead to a final diagnosis. Diverticulitis manifests with mild, smooth bowel wall thickening and no lymphadenopathy. Epiploic appendagitis manifests with central areas of high attenuation and a hyperattenuated rim, in addition to its characteristic location adjacent to the colon. In contrast, omental infarction is always centered in the omentum. The most specific finding of appendicitis is a dilated, fluid-filled appendix. Correct noninvasive diagnosis is important because treatment approaches for these conditions range from monitoring to surgery. Copyright RSNA, 2004

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Preoperative T and N staging of colorectal cancer: accuracy of contrast-enhanced multi-detector row CT colonography--initial experience.

Lorenzo Bonomo, Maurizio Fuschi, Tiziana Marinelli … (2004)

To evaluate the accuracy of contrast material-enhanced multi-detector row computed tomographic (CT) colonography for preoperative staging of colorectal cancer. Forty-one patients with colorectal carcinoma underwent preoperative contrast-enhanced multi-detector row CT colonography. Images were obtained in the arterial (start delay of 35 seconds) and portal venous (start delay of 70 seconds) phases. The arterial phase was focused on the suspected region of neoplasm, whereas the venous phase included the whole abdomen and pelvis. Two radiologists independently evaluated the depth of tumor invasion into the colorectal wall (T) and regional lymph node involvement (N) on transverse CT images alone and in combination with multiplanar reformations (MPRs). Disagreements were resolved by means of consensus. CT findings were compared with pathologic results, which served as the reference standard. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were assessed. Differences in accuracy for T and N staging were assessed by using the McNemar test. In T staging, overall accuracy was 73% when transverse images were evaluated alone and 83% when they were evaluated in combination with MPRs. This difference was not significant. N staging was associated with an overall accuracy of 59% with transverse images alone and 80% with combined transverse and MPR images (P <.01). Contrast-enhanced multi-detector row CT colonography is an accurate technique for preoperative local staging of colorectal tumors. Copyright RSNA, 2004

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Author and article information

Journal

Journal ID (nlm-ta): Korean J Radiol

Journal ID (publisher-id): KJR

Title: Korean Journal of Radiology

Publisher: The Korean Society of Radiology

ISSN (Print): 1229-6929

ISSN (Electronic): 2005-8330

Publication date (Print): Mar-Apr 2010

Publication date (Electronic): 22 February 2010

Volume: 11

Issue: 2

Pages: 211-221

Affiliations

[1 ]Department of Radiology, Cheonan Hospital, Soonchunhyang University, Cheonan 330-720, Korea.

[2 ]Department of Pathology, Cheonan Hospital, Soonchunhyang University, Cheonan 330-720, Korea.

Author notes

Address reprint requests to: Sang Won Kim, MD, Department of Radiology, Cheonan Hospital, Soonchunhyang University School of Medicine, 23-20 Bongmyeong-dong, Cheonan-si, Choongnam 330-720, Korea. Tel. (8241) 570-3503, Fax. (8241) 579-9026, rad2000@ 123456hanmail.net

Article

DOI: 10.3348/kjr.2010.11.2.211

PMC ID: 2827785

PubMed ID: 20191069

SO-VID: c5298111-0cf3-4b2a-b2ac-74e2ac375efc

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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

CT Findings of Colonic Complications Associated with Colon Cancer

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Most cited references 20

Adult intestinal intussusception: CT appearances and identification of a causative lead point.

Disproportionate fat stranding: a helpful CT sign in patients with acute abdominal pain.

Preoperative T and N staging of colorectal cancer: accuracy of contrast-enhanced multi-detector row CT colonography--initial experience.

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